What Causes a Complicated Migraine?

Migraine comes in a variety of shapes and sizes, all similar, yet all unique. Many migraines are first noticed with the aura: visual and hearing disturbance, nausea, and vomiting are all part of the aura. When the aura ends, a dull ache signals the beginning headache. Most migraines go on to develop into a throbbing, excruciating pain at the temples, front, or back of the head.

The complicated migraine is different.

Define Complicated Migraine

A complicated migraine has the disturbances of an aura, but the symptoms are prolonged, often lasting into or through the headache phase itself. Whereas a common migraine’s aura is done in 20 minutes to an hour, it continues with a complicated migraine, sometimes lasting throughout the hours or days of pain.

Four Forms of Complicated Migraine

Complicated migraine has four forms.

1. Basilar migraine: A typical migraine aura progresses to developing neurological symptoms related to the brainstem. Affecting both sides, the headaches of this migraine are often at the back of the head, and may cause severe vomiting.

2. Hemiplegic migraine: Quite possibly inherited, this migraine causes stroke-like symptoms with loss of muscle strength and/or sensory loss.

3. Ophthalmoplegic migraine: This migraine causes partial or complete paralysis of the nerves needed for eye movement.

4. Retinal migraine: Visual symptoms come from the retina itself rather than from the portion of the brain involved in vision.

In all of these forms, complicated migraine seems to carry an increased risk of permanent neurological changes.

Causes of Complicated Migraine

The causes of complicated migraine are not clearly understood. In some cases, they are believed to begin with a spasm, or partial closing, of arteries leading to the brain. The spasm decreases blood supply to part of the brain, causing the aura. The arteries then relax too much, giving a surge of blood, which causes pain. This artery action involves dopamine and serotonin, chemicals normally found in the brain, but when in abnormal amounts, able to cause blood vessels to act in uncharacteristic ways.

Triggers of Complicated Migraine

Various triggers also are thought to initiate complicated migraine. Different people may have different triggers.

* Certain foods such as alcohol, cheese, chocolate, and monosodium glutamate (MSG. (MSG is a flavor enhancer used in many foods, including Chinese.)
* Contraceptives (birth control pills)
* Missing a meal
* Sleep pattern interruption
* Smoking
* Stress and tension.

Genetic Disposition to Complicated Migraine

All migraines are thought to run in families. Some, like the hemiplegic migraine, have been linked to chromosomes.

What to Do

If you think you may have complicated migraine, see your health care provider immediately. This migraine is severe and can cause long-lasting neurological changes in the brain. Your physician may want to begin treatments to prevent future episodes rather than treat them after they have begun.